Acute liver failure due to widespread carcinomatous infiltration of the liver by breast cancer carries a grave prognosis. The disease course is fulminant and deranged hepatic functions and poor performance status make chemotherapy difficult. Our patient was a 46-year-old lady with breast cancer who presented with acute liver failure and hepatic encephalopathy secondary to extensive liver metastases and who was successfully treated with chemotherapy (Nab-paclitaxel) and (immunotherapy) Trastuzumab. There is no such report of concomitant use of nab-paclitaxel and trastuzumab in acute liver failure in world literature. Usually, these patients are administered palliative care only, however, such nihilistic approaches prevent us from salvaging such patients. It is possible to salvage a proportion of this high-risk group of patients with immediate institution of suitable systemic therapy and appropriate supportive care. We present the report of such a case.